Bilateral Frontoparietotemporal Craniectomy for Traumatic Brain Injury: A Case Report.

There is no conclusive agreement on the optimal approach to managing severe traumatic brain injury. This article details the methodology and outcomes of bilateral frontoparietotemporal decompression surgery performed on a three-year-old patient with severe traumatic brain injury. As the patient had fixed dilated pupils, GCS (Glasgow coma scale) 4, and marked edema in the frontal and parietal regions, the Kjellberg approach was modified, and decompression including part of the parietal bone was performed. The patient was intubated and sedated in the intensive care unit for one week postoperatively. After extubation, the patient had reactive pupils and a GCS of 13. The patient underwent a cranioplasty two months after the trauma, combining the bone grafts placed in the abdomen. The patient was followed for three days after cranioplasty and discharged with a GCS:15 and intact motor examination.

Comparison of TachoComb and TissuDura in Terms of Adverse Effects and Complications in Duraplasty in Rats.

AIM: To compare two synthetic graft materials, TachoComb®, a fibrin sealant composed of collagen, fibrinogen, thrombin and aprotinin and TissuDura®, a collagen-based biomatrix. MATERIAL AND METHODS: Thirty Sprague?Dawley rats were randomly divided into three groups with 10 animals in each group. A dural defect was created on the left parietal bone of each animal, and the dural defect was repaired using either TachoComb® (TachoComb group) or TissuDura® (TissuDura group). Sham animals did not receive any dural graft. After 21 days of follow-up, the brain was dissected, and inflammation, oedema, gliosis and foreign body reaction in the bone and parenchymal tissue were investigated histopathologically. RESULTS: The TachoComb group showed significantly greater inflammation, gliosis and parenchymal foreign body reaction compared with the sham group. By contrast, the TissuDura group had significantly lower gliosis and insignificantly less inflammation in the bone and parenchymal foreign body reaction compared with the TachoComb group. CONCLUSION: In conclusion, our results suggest that TissuDura® may be considered more biocompatible than TachoComb® in duraplasty.

The Preventive Effect of Curcumin on the Experimental Rat Epidural Fibrosis Model.

OBJECTIVE: The aim of the study was to evaluate the effect of systemically administrated curcumin on the prevention of peridural fibrotic tissue and adhesion formation in a rat laminectomy model. METHODS: Thirty-two Wistar albino rats were randomly selected and equally divided into 4 groups as follows: negative control group (group I) did not undergo operation; positive control group (group II) underwent laminectomy without treatment; group III (low-dose curcumin; 100 mg/kg); and group IV (high-dose curcumin; 200 mg/kg). Curcumin was administered intraperitoneally per day for 7 days after surgery starting from day 0. Twenty-eight days after surgery, T12 and L4 vertebral columns, paraspinal tissues, and epidural scar tissue were dissected en bloc and prepared for histopathologic examinations. All specimens were examined for inflammation, epidural fibrosis (EF), foreign body reaction, medulla spinalis retraction, granulation tissue, and arachnoid involvement. A Kruskal-Wallis test followed by a Dunn multiple comparison test were used for statistical analysis, and a P value <0.05 was considered as statistically significant. RESULTS: Curcumin treatment significantly reduced inflammation, foreign body reaction, granulation tissue formation, medulla spinalis retraction, and EF formation compared with positive control group (P < 0.05); however, no significant differences were found between the 2 groups that received different doses of curcumin. CONCLUSIONS: The results of the present study showed that systemic administration of curcumin was effective in reducing EF formation, inflammation, granulation tissue formation, medulla spinalis retraction, and foreign body reaction in the laminectomy area. Our results suggest that antiinflammatory activities of curcumin are beneficial for attenuation of EF formation.

Analysing the blood-stemming effect of Ankaferd Blood Stopper in medulla spinalis surgery

Background/aim: The aim of this study was to investigate the possible toxicity of the Ankaferd Blood Stopper (ABS) on the neural system. Materials and methods: Thirty Sprague Dawley rats were randomized into ABS (n: 15) and control (n: 15) groups. Following the anaesthetic induction, total laminectomy was performed to the lower thoracic, and upper lumbar areas in both groups and medulla spinalis was exposed. Two myelotomies were performed on the medulla spinalis. One millilitre ABS was applied to the incision site in the ABS group, and one millilitre 0.9% saline solution was applied in the control group. Rats were observed for 15 days regarding general behaviour, neurological signs, mobility, and signs of infection. Sixteen days later, all rats were decapitated under anaesthesia. Medulla spinalis was removed en bloc from all rats and was stained with Heamatoxylin & Eosin and luxol fast blue. Results: There was no significant difference between the ABS group and the control group regarding oedema, gliosis, the intensity of inflammatory cells, the presence of neuronal degeneration, neuron counts, and myelin degeneration. Conclusion: No clinical or histopathological evidence for the neurotoxic effect of the ABS was observed in the present study. Our findings might precipitate the use of ABS on human subjects regarding medulla spinalis surgery.

Endoscopic Training Model for Intranasal Transsphenoidal Hypophysis Surgery Using a Skull Model and Chicken Wings.

AIM: To evaluate the feasibility of an experimentally designed model for training on endoscopic intranasal transsphenoidal hypophysis surgery. MATERIAL AND METHODS: In this experimental study, a surgical training model for endoscopic transsphenoidal hypophysis surgery was designed to simulate real life surgical challenges, such as drilling through the sella turcica under endoscopic vision. This laboratory experiment was repeated at 1-week intervals and it was observed that surgeons improved their skills. The compatibility of the training model was evaluated as either poor, acceptable or perfect. RESULTS: The results revealed that according to earlier data, greater success occurred in tests conducted after 1 week. Three new specialist neurosurgeons also expressed that their self-confidence increased during the second procedure. CONCLUSION: This laboratory study will result in improved use of microsurgical instruments and understanding of the threedimensional surgical field, as well as the development of manual dexterity. We believe that this model will contribute to the practical training of endoscopic hypophysis surgery.

The Microneurosurgical Training Model for Intrinsic and Extrinsic Brain Tumor Surgery Using Polyurethane Foam and Fresh Cadaveric Cow Brain: An Experimental Study.

OBJECTIVE: To evaluate the feasibility of an experimentally designed brain tumor model consisting of polyurethane foam and fresh cadaveric cow brain for the surgical training of the technique for tumor ablation. METHODS: A laboratory-training model was created for microneurosurgical intervention of intrinsic brain tumor ablation covering microdissection of the brain tissue and opening of the pia mater, dissection and separation of the sulcal and cisternal structures, and dissection and removal of the tumor tissue. The left front parietal lobe was used as the area of interest for this experimental study. One-centimeter cube polyurethane foam was injected 2-cm deep inside the brain tissue using a plastic injection tube. After 5 minutes, the model was ready to use under the operating microscope for dissection, separation, and removal of the tumor tissue. The compatibility of the training model also was evaluated as poor, acceptable, and perfect. RESULTS: Ten stripped fresh cadaveric cow brains were used in this experimental feasibility study. The compatibility of the model was evaluated as poor, acceptable, and perfect in 1, 6, and 3 subjects, respectively. CONCLUSIONS: In intrinsic brain tumor ablation, surgical manipulations of sulcal, cisternal, and fissural dissection must be undertaken while preserving vital neural and vascular structures. We believe that our model holds promise in developing the technical skills of neurosurgeons in training.

Histopathological evaluation of mesenchymal stem cells in the healing of anastomosed carotid arteries.

The objective of this study was to evaluate the influence of mesenchymal stem cells on the healing of experimental carotid artery anastomoses histopathologically. Twenty-four female Sprague-Dawley rats were used in this study. After random separation of the subjects into two groups, in both groups carotid arteries were transected and anastomosed in end-to-end fashion. Anastomoses were locally treated with 1 ml 0.09% NaCl, and 1 ml mesenchymal stem cell suspension (1×106 cells) in control and trial groups, respectively. Anastomoses were wrapped with an 8 mm sheet of surgicel and soaked with BioGlue in order to sequestrate the stem cells. After patencies were confirmed via Doppler USG, surgical site was closed with 2/0 silk sutures. Histopathological evaluation was carried out after 4 weeks. In respect to endothelial continuity, vessel patency (along with presence or absence of restenosis), integrities of internal and external elastic laminae, muscularis and adventitia; no statistically significant differences were present between the trial and control groups. In Trial and Control Groups, luminal thrombus was present in 8 (66.6%) and 3 (25%) of the 12 subjects, respectively. The difference was statistically significant (P < 0.05). Recanalization was present in 6 subjects in trial group; 1 subjects in Control Group, respectively. Our results suggest that local administration of mesenchyme stem cell does not have a positive influence on success of an anastomosis.

Localization of Intracranial Lesions Using Superficial Stereotaxic Cranial Lesion Locator Based on Magnetic Resonance Images.

BACKGROUND: Detection of a deep-seated lesion located in the brain parenchyma and major neuroanatomical sites is a critical issue in neurosurgery. Some neurosurgical cranial navigation systems have been developed that are available; however, some preparation is necessary, including the installation of complex computer software programs and obtaining specific neuroradiological images. OBJECTIVE: The purpose of this experimental study was to design and evaluate a superficial stereotaxic frameless lesion locator in order to localize mass lesions within the brain. METHODS: A superficial stereotaxic frameless lesion locator system was designed using cardboard and the Cartesian coordinate system as a reference framework. This material was used in a model creating printed magnetic resonance images in the superficially marking of the lesion. This material easily located the lesion placement and superficially projected the lesion location. RESULTS: The results of this study revealed that the superficial stereotaxic frameless lesion location procedure using a coordinate cardboard locator is a safe, fast, and simple procedure. This procedure provides an accurate means of locating the target lesion seated within the brain parenchyma. When compared with other models, we found that this device is reliable and has a high rate of superficial lesion detection. CONCLUSION: A superficial lesion locator may be used in clinical practice. This experimental study demonstrated the usability and reliability of the procedure. Additional detailed investigations are necessary to improve the procedure.

Using of the Chicken Wing's Bone in the Microneusurgical Training Model for Microdrilling.

BACKGROUND AND OBJECTIVE: Repetitive practicing of microneurosurgical techniques in experimental laboratory using real surgical instruments on training models is extremely important before starting the real surgical interventions. The modeling of the surgical steps with creating of suitable laboratory models is also another important issue in the successfully gaining of microneurosurgical practice. MATERIALS AND METHODS: In this experimental study, it was created a laboratory training model for microneurosurgical drilling of cranial bones including the close location with the neural and vascular structures. All steps of this study were performed under the operating microscope. Twenty-five fresh chicken wings obtained from supermarket were used for this study. The difficulty and suitability of the model was evaluated in terms of the usability in the training of microneruosurgical microdrilling. Difficulty of the procedure was divided as three degree (very easy, easy, and difficult). The objective criterion for the evaluation of the difficulty of the procedure was the protection of the neurovascular and muscular structures during the procedure. RESULTS: The suitability of the procedure was also evaluated within three groups as bad, good, and perfect. In four (16%) chicken wing's bone, the difficulty of the microdirilling was evaluated as difficult. Fifteen (60%) of the chicken wing's bones were microsurgically drilled with easy procedure. The remaining six (24%) of the wing's bone microdrilling was evaluated as very easy procedure. The suitability of the model was evaluated as bad in three (12%) of the chicken wing's bone. The suitability was found as good in 16 (64%) of the bones. In the remaining three (24%) of the chicken wing's bone microdrilling, the suitability of the model was evaluated as perfect. CONCLUSION: Microsurgical drilling of the chicken wing's bone without any vascular and muscular injury is accepted as the indication of the successfully surgical microdrilling process. Consolidation of the surgical practice in a laboratory setting, grasping and using of microsurgical instruments, can be repeated in several times in this model. We believe that this model will contribute to the practical training of microneurosurgery.

Reconsideration of Neurogenic Pulmonary Edema as Source of Metastatic Cerebral Abscess Following Subarachnoid Hemorrhages: A Preliminary Study.

BACKGROUND: Subarachnoid hemorrhage (SAH) may be a cause of neurogenic pulmonary edema (NPE). It is well known that lymphatic fluid draining by thoracic duct to lungs consists of many dangerous metabolites, degraded tissue particles, and microbiologic pathogens. However, not enough studies have investigated whether NPE causes septicemia or not. In this study, we retrospectively examined our experimental materials to determine whether there is a meaningful relationship between NPE and cerebral abscess formation. METHODS: Forty-two rabbits were divided into 3 groups: Control (n = 5), SHAM (n = 7), and SAH (n = 30) with severe neurogenic lung edema detected in rabbits. The SHAM and SAH groups received 1 mL saline and 1 mL autologous arterial blood into the Sylvian cisterna, respectively. Weight, heartbeat, respiration rate, and blood pressure were recorded by routinely using monitoring devices. All multilevel lungs and brain tissue microsections were examined by stereologic and Cavalier methods. For statistical analysis, NPE criteria and the numbers of abscess or abscess resembling cores in the brains were estimated in all groups and compared. The Mann Whitney-U test was used to analyze the results statistically. RESULTS: All rabbits were around 4 years old; body weight was between 3.94 and 4.5 kg; normal heart rhythm rate was found between 251 ± 39/minutes and 281 ± 30/minutes; and respiration rate was between 24 ± 5/minutes and 36 ± 7/minutes. Histopathologic examinations showed that abscess formations frequently spread in middle cerebral arterial territories of all animals in the NPE-detected rabbits. While average abscess numbers were estimated as 3 ± 1 in 7 animals (n = 7; P < 0.005) in severe NPE-detected rabbits, only 1 ± 1 abscess core was detected in a less severe NPE that developed in 3 (n = 3; P < 0.05) animals. The vasospasm index values of pulmonary arteries (PAs) of all animals were 1.233 ± 0.065 in the control group; 1.567 ± 0.0430 in the SHAM group, and 2.890 ± 0.0453 in the SAH group (P < 0.05). CONCLUSIONS: This experimental study showed that NPE is a relatively common pathology following experimental SAH in rabbits. The NPE is frequently complicated with brain abscess as shown in this study. The pathophysiologic mechanism was concluded, as NPE may be responsible for cerebral abscess development via bacteria/cytotoxic particles conveyed by thoracic duct to lungs and transferred from the ruptured alveoli-capillary membrane to the brain by way of systemic circulation.

Using of Fresh Cadaveric Cow Brain in the Microsurgical Training Model for Sulcal-Cisternal and Fissural Dissection.

OBJECTIVE: The aim of this experimental study was to evaluate the feasibility of using fresh cadaveric cow brain as in a training model for microsurgical dissection of sulcus, cisterns, and fissure. METHODS: Experimental microneurosurgical activities in this study were performed under the operating microscope. Bilateral sylvian cisterns, interhemispheric fissure, and hemispheric sulcus of the fresh cadaveric cow brain were used as an interested area for this experimental study. The dissection was continued reaching down to the floor of the cistern and total dissection of the middle cerebral artery inside the cisternal space. The suitability of a cow brain as a training model for sylvian fissure microdissection was evaluated as three groups; bad, good, and perfect. RESULTS: Ten uncovered fresh cadaveric cow brains were used in this experimental feasibility study. The suitability of the experiment for training model was evaluated as bad in (1) 10% of the fresh cadaveric cow brains. The suitability was found as good in (6) 60% of the procedures. In the remaining (3) 30% of the brain dissection, the suitability of the experiment was evaluated as perfect. CONCLUSION: In conclusion, performing the sulcal, cisternal, and fissural dissection and protecting the neural and vascular tissue from the mechanical bruising effect of metallic microsurgical instruments are feasible as shown in this study. We believe that this training model will contribute to the practical micro-neurosurgery. Additionally, it provides adequate performance for the microsurgical intervention.

Proconvulsant Effect of Papaverine on Penicillin-Induced Epileptiform Activity in Rats.

AIM: Papaverine is a vasodilator agent that is an opium alkaloid. It exhibits its effects by inhibiting the phosphodiesterase enzyme. Papaverine administration is widely used to avoid symptomatic vasospasm after subarachnoid hemorrhage. We aimed, in this research, to study the effects of papaverine on the epileptic discharges stimulated by penicillin. MATERIAL AND METHODS: Adult female Wistar rats (220±30 g) were included in this research (n=30). Rats were anesthetized with urethane (1.25 g/kg) and then the left cerebral cortex was reached by opening a burr hole with a drill. Penicillin G sodium salt (500 IU)(200 IU/1 µl) was injected into the left lateral ventricle to produce epileptiform activity. Thirty minutes before penicillin G sodium injection, papaverine was administered at doses of 5, 10, 20 or 40 mg/kg intraperitoneally. RESULTS: There was no significant difference in spike frequency between the control group and the groups given 5 mg/kg, 10 mg/ kg or 40 mg/kg papaverine, while 20 mg/kg papaverine significantly increased the spike frequency (p < 0.05). CONCLUSION: Papaverine augments the epileptiform activity produced by penicillin injection. It is important to remember that papaverine might induce convulsions in patients who have epilepsy. More research is required to understand the mechanisms of the proconvulsant influence of papaverine in epilepsy.

The histopathological and stereological assessment of the effect of topically administered leptin on cerebral vasospasm in an experimental subarachnoid hemorrhage model

Background/aim: Cerebral vasospasm is a term that refers to prolonged, slowly progressing but reversible pathological narrowing of cerebral arteries occurring several days after subarachnoid hemorrhage (SAH), usually accompanied by a decrease in perfusion distal to the affected artery. Leptin is an endogenous polypeptide hormone that can be carried freely and bound to protein in the blood. Materials and methods: We investigated the superiority of topical application of leptin that may make a contribution to the development of new treatment modalities for unconscious patients in brain injury intensive care units and its preventive effect, which is considered to have multifactorial pathogenesis on cerebral vasospasm occurring after SAH via stereological studies of the basilar artery. Results: When mean serum leptin levels of the groups were compared, statistically significant differences were observed between the control and topical leptin-treated groups in favor of the treated groups with respect to serum leptin levels (P < 0.05). In the topical leptin-applied group, a significant difference in favor of vasodilatation was observed in the measurements of the basilar artery luminal area (P < 0.05). Conclusion: In accordance with the results, the topical administration of leptin can be used in the prevention of vasospasm, especially in unconscious patients with subarachnoid hemorrhage.

Postlaminectomy Bone and Scar Formations in Presence of Ankaferd Blood Stopper and Bitter Melon (Momordica Charantia): An Experimental Study.

AIM: A quantitative model of postlaminectomy was designed in rats. The effects of Momordica Charantia (MC) and Ankaferd blood stopper (ABS) on the bone and scar formation after laminectomy were concurrently evaluated. MATERIAL AND METHODS: Eighteen adult Wistar albino rats underwent lumbar laminectomy at L2-L3 vertebral levels, and were randomly assigned to one of three groups of six rats each. The Treatment group received MC and ABS treatment and the Control group was left untreated. Rats were sacrificed 4 weeks after treatment. Then; the lumbar spine was excised en-block, fixed and decalcified. Sections were stained with hematoxylin and eosin (H&E) and Masson"s trichrome, and evaluated for peridural fibrosis (PF), new bone formation, and vascular proliferation. RESULTS: Total volume of new bone in the MC group was significantly increased in comparison to the Control group (p < 0.05). Also; there was highly significant increase in terms of the total volume of fibrous tissue in the MC and ABS groups when compared with the Control group (p < 0.01). Besides; there was a highly significant difference between the MC and the Control groups (p < 0.01) in point of total volume of vessel. CONCLUSION: Both MC and ABS are not convenient to prevent the PF formation and MC may promote new bone formation and angiogenesis after lumbar laminectomy in rats.

Three Dimensional Microanatomy of the Ophthalmic Artery: Spontaneous Intracranial-Extracranial Anastomosis Site within the Orbital Cavity.

AIM: The aim was to evaluate three-dimensional structure of the ophthalmic artery (OphA). MATERIAL AND METHODS: The raw data of the Three-dimensional Computerized Tomography Angiography (3D-CTA) were transferred to computer and recorded in a software program. RESULTS: The study group consisted of 45 (24 female and 21 male) patients. The mean age of the patients was 56 ± 9.5 years. It was found that the entry point of the OphA to the orbital cavity was inferior to the optic foramen in 29 (64.44%) of the cases. The length of the postcanalicular-prelacrimal was 0.54 ± 0.13 centimeters at the right side and 0.51 ± 0.13 centimeters at the left side. The distance of the postlacrimal-presupraorbital segment was 0.43 ± 0.11 centimeters at the right and left sides. The location of the anastomosing site was 0.97 ± 0.42 centimeters from the supraorbital notch. CONCLUSION: The results of this study showed us that this technique could be used in the evaluation of the three-dimensional microsurgical anatomy of the OphA and its critical extracranial-intracranial anastomosing site.

Three-Dimensional Microsurgical Anatomy of the Choroid Plexus Using the Volume Rendering Technique.

AIM: The choroid plexus (CP) is a specific anatomical structure producing cerebrospinal fluid into the ventricular space. The three-dimensional anatomical structure of the choroid plexus located within the lateral ventricle may be evaluated by using the three dimensional volume rendering technique (3D-VRT) from acquired two-dimensional contrast enhanced computerized tomographic images. MATERIAL AND METHODS: The raw data of Three-dimensional Computerized Tomography Angiography (3D-CTA) were transferred into the computer and recorded in a software program. These images were evaluated in terms of anatomical shape, borders, extensions length and dimensions. RESULTS: The patient group consisted of 57 (27 female and 30 male) patients. The mean age of the patients was 55±9 years. In male individuals, the distance of the superior tip from Frazier's point was 7.96±0.71 centimeters at the right side. In males, the distance of the inferior tip of the CP was estimated as 1.93±0.26 centimeters posterior-lateral from the anterior clinoid process, 1.64±0.23 centimeters posterior-lateral from the bifurcation of internal carotid artery, and 2.86±0.23 centimeters posterior-medial from the bifurcation of middle cerebral artery on the right side. CONCLSION: The results of this study showed us that this technique could be used in the three-dimensional evaluation of some anatomical structures such as the choroid plexus.

Fusiform Enlargement of the Superficial Temporal Artery in the Cases with Intracranial Aneurysm.

AIM: The superficial temporal artery is one of the main terminal branches of the external carotid artery. This artery ascends through the lateralposterior margin of the zygomatic arch to reach the temporal region of the scalp. The superficial temporal artery divides its frontal and parietal branches around the zygomatic arch. MATERIAL AND METHODS: The raw data of the Three-dimensional Computerized Tomography Angiography (3D-CTA) were transferred to computer and recorded in a software program. This software program created the three-dimensional images of the superficial temporal artery using these transferred raw data with volume rendering technique. RESULTS: Fifteen cases (5 female and 10 male, mean age 54.26 ± 12.35 years) with intracranial aneurysm were evaluated in terms of the type, location and dimensions of the fusiform enlargements. Fusiform enlargement was bilateral in eleven of the cases. Remaining four cases have unilateral fusiform enlargement of the superficial temporal artery. CONCLUSION: Fusiform enlargement of the superficial temporal artery may be seen in the cases with intracranial aneurysms. 3D-CTA should be carefully evaluated in the demonstration of extracranial-intracranial vascular pathologies.

The Contribution of Three-Dimensional Computerized Tomographic Angiography in the Head Positioning of the Patients with Middle Cerebral Artery Aneurysms.

Surgical intervention is a gold standard technique for ruptured and unruptured middle cerebral artery bifurcation aneurysm. Before surgical intervention it is necessary to know the three-dimensional shape, surgical position, projection and position of the aneurysm and the course of the parent artery. In a demonstrative case with middle cerebral artery aneurysm, using the OsiriX MD image processing software for DICOM images, it was demonstrated the position of the aneurysm neck, the projection of the aneurysm and the course of the M1 segment in relation with dynamic rotation and extension of the head. These dynamic videographic neuroradiological images may enhance the surgical anatomic perspective of the surgeon before the surgical intervention.

Electrophysiological and histopathological effects of mesenchymal stem cells in treatment of experimental rat model of sciatic nerve injury.

AIM: The aim of this study was to evaluate electrophysiological and histopathological effects of mesenchymal stem cells in treatment of sciatic nerve injury. MATERIAL AND METHODS: Thirty-two female Spraque-Dawley rat were used in this study. Eight rats were used as a reference group in electrophysiological analysis for evaluation of non-injured nerve recordings (Control Group). Twenty-four rats were used for experimental evaluation. Twelve rats were anastomosed without treatment with mesenchymal stem cells (Sham Group) and twelve other rats were anastomosed and treated with mesenchymal stem cells (Stem Cell Group). Surgicel and bioglue were used in anastomosed line in both Groups. Eight weeks after the surgery, electrophysiological evaluation of rats was performed and, then, rats were decapitated under anesthesia and specimens including sciatic nerves and anastomosed line were taken for histopathological evaluation. Electromyography and nerve conduction velocity testing and histopathological scoring including rate of Wallerian degeneration, and neuroma and scar formation were evaluated for both Groups. RESULTS: There were no statistically significant differences between Sham and Stem Cell Groups with respect to histopathological evaluation. However, nerve conduction velocity showed significant difference between groups (P = 0.001). Nerve conduction velocity was significantly improved in Stem Cell Group when compared to Sham Group. CONCLUSION: In this study, based on nerve conduction velocity data, it was concluded that treatment with mesenchymal stem cells during end-to-end anastomosis improves functional regeneration.